The Relationship between Nurses' Perception of Barriers Magnitude and their Demographic Characteristics

Sedigheh Iranmanesh*, Marjan Banazadeh**, Mansoure Azizzadeh Forozy***
* Research scholar, Kerman Medical University Kerman, Iran.
** Student, Kerman Medical University Kerman, Iran.
*** Nurse Educator, Neuroscience Research Centre, Institute of Neuropharmacology University of Medical Science, Kerman, Iran.
Periodicity:February - April'2015
DOI : https://doi.org/10.26634/jnur.5.1.3492

Abstract

Nurses face numerous challenges in providing pediatric EOL care. Their perceptions of existing barriers which are affected by their personal and professional experiences related to death and dying influence quality of care for children. The purpose of this paper is to assess the relationship between nursing staffs' demographic characteristics and their perception of barriers magnitude. Using a translated modified version of (NSCCNR-EOL) questionnaire, the relationship between 151 nurses' perception of barriers magnitude and their demographic characteristics was assessed. The item “families not accepting poor child prognosis” belonging to patient-family related category achieved the highest PBM score (5.04). The item “continuing to provide advanced treatments to dying children because of financial benefits to hospital” belonging to the organizational related category achieved the lowest PBM score (2.19) Participants' family and close friends' death experience positively correlated with perceived organization-related barriers magnitude. Also participants' nursing experience positively correlated with perceived health-care professional related barriers magnitude. This study provides nurses with some valuable insights about effect of nurses' experiences on their perceptions of EOL care barriers. Raising nurses' self-awareness of their perception, accompanied by interventions is required in providing educational programs. This may raise nurses' awareness of the barriers and learn how to manage them.

Keywords

Relationship, Nurses' Perception, End of Life Care Barriers, Terminally ill Children, South East Iran.

How to Cite this Article?

Iranmanesh, S., Banazadeh, M., and Forozy, M.A. (2015). The Relationship between Nurses' Perception of Barriers Magnitude and their Demographic Characteristics. i-manager’s Journal on Nursing, 5(1), 11-23. https://doi.org/10.26634/jnur.5.1.3492

References

[1]. Abdel-Khalek, A., Al-Kandari, Y.(2007). “Death Anxiety in Kuwaiti Middle-aged Personnel”. Omega: Journal of death and dying, Vol. 55, No. 4, pp. 297-310.
[2]. Abu Hasheesh, M.O., AboZeid, S.A., El-Said, S.G., Alhujail, A.D. (2013). ”Nurses' characteristics and their Attitudes toward Death and Caring for Dying Patients in a Public Hospital”. Health Science Journal, Vol. 7,No. 4, pp. 384-394.
[3]. Anghelescu, D. L., Oakes, L., Hinds, P. S. (2006). “Palliative care and pediatrics”. Anesthesiology Clinics of North America, Vol. 24, pp.145-161.
[4]. Asadi-Lari, M., Madjd, Z., Akbari, M. E. (2008).“The need for palliative care services in Iran; an introductory commentary”. Iranian Journal of Cancer Prevention, Vol.1, No.1, pp.1-5.
[5]. AtashzadehShorideh, F., Ashktorab, T., Yaghmaei, F. (2012).” Iranian intensive care unit nurses' moral distress: A content analysis”. Nurse Ethics, Vol.19, No.14, pp. 464–478.
[6]. Barrere, C., Durkin, A., LaCoursier, S. (2008).“The influence of End-of-Life education on attitudes of nursing students”. International Journal of Nursing Education, Vol. 5 No.1, pp, 1-18.
[7]. Beckstrand, R. L., Kirchhoff, K. T. (2005). “Providing endof- life care to patients: Critical care nurses' perceived obstacles and supportive behaviors”. American Journal of Critical Care, Vol.14, No.5, pp 395-403.
[8]. Beckstrand, R. L., Moore, J., Callister, L., Bond, E. A. (2009). “Oncology nurses' of obstacles and supportive behaviors at the end of life”. Oncology Nursing Forum, Vol. 36, pp. 446-453.
[9]. Beckstrand, R. L., Rawl N. L., Calliste, L., Mandleco B. L. (2010). “Pediatric Nurses' Perceptions of Obstacles and Supportive Behaviors in End-of-Life”. American Journal of Critical Care, Vol .19, No. 6, pp. 543-552.
[10]. Beckstrand, R. L., Smith, M. D., Heaston, S., Bond, A. E. (2008). “Emergency nurses' perceptions of size, frequency, and magnitude of obstacles and supportive behaviors in end-of-life care”. Journal of Emergency Nursing, Vol. 34, No. 4, pp. 290-300.
[11]. Benner, P. (1984). “From novice to expert: Excellence and power in clinical nursing practice. Menlo Park”, CA: Addison-Wesley.
[12]. Bennett, H. A. (2012). Guide to End of Life Care: Care of children and young people before death, at the time of death and after death. P14. www.togetherforshortlives. org.uk/...A_Guide_to_End_of_Life_Care_5.
[13]. Burns, J. P., Mitchell, C., Griffith, J. L., Truog, R. D. (2001). “End-of-life care in the pediatric intensive care unit: Attitudes and practices of pediatric critical care physicians and nurses”. Critical Care Medicine, Vol .29, No.3, pp. 658- 664.
[14]. Canadian Institute for Health Information (2011). Health care use at the End of Life in Atlantic Canada. https://secure.cihi.ca/.../end_of_
[15]. Carper, B. (1978).“Fundamental patterns of knowing in nursing”. In L.H. Nicoll (Ed.), Perspectives on nursing theory Vo.1, No.1, pp. 13-24).
[16]. Carter, B. S., Hubble, C., Weise, K. L. (2006). “Palliative medicine in neonatal and pediatric intensive care”. Child and Adolescent Psychiatric Clinics of North America, Vol. 15, No. 5, pp. 759-777.
[17]. Crozier, F., Hancock, L. E. (2012).“Pediatric Palliative Care: Beyond the End of Life”. Pediatric Nursing, Vol. 38, No. 4, pp. 198-203.
[18]. Crump, S., Schaffer, M. A., Schulte, E. (2010). ”Critical Care Nurses' Perceptions of Obstacles, Supports, and Knowledge Needed in Providing Quality End-of-Life Care”. Dimensions of Critical Care Nursing, Vol. 29, No. 6, pp. 297- 306.
[19]. Davies, B., Sehring, S. A., Partridge, J. C., Cooper, B.A., Hughes, A., Philp, J. C, Kramer, R. F. (2008). Barriers to Palliative Care for Children: Perceptions of Pediatric Health Care Providers. Pediatrics, Vol.121, pp. 282-288.
[20]. Docherty, S. L., Miles, M. S., Brandon, D. (2007). “Searching for "the dying point:" Providers' experiences with palliative care in pediatric acute care”. Pediatric Nursing, Vol. 33, No. 4, pp. 335-341.
[21]. Dunn, K. S., Otten, C., Stephens, E. (2005). “Nursing experience and the care of dying patients”. Oncology Nursing Forum, Vol. 32, No.1, pp. 97-104.
[22]. El-Kurd LCSW, ACHP-SW Hoag CARES Team. (2013). Cultural Diversity and Caring For Patients from the Middle East. PCQN Conference Call.
[23]. Farsi, Z., Dehgha-Nayeri, N., Negarandeh, R., Broumand, S. (2010). “Nursing profession in Iran: an overview of opportunities and challenges”. Japan Journal of Nursing Science, Vol.7, No.1, pp.9–18.
[24]. Feudtner, C., Santucci, G., James, A., Feinstein, C., Snyder, R., M.T, Rourke., T.I, kang. (2007). “Hopeful Thinking and Level of Comfort Regarding Providing Pediatric Palliative Care”: A Survey of Hospital Nurses. Pediatrics, Vol. 119, No. 1, pp. 186-192.
[25]. Fortney, A. C. (2012). Evaluating Quality of Death at the End of Life in Neonates in the NICU. Ph.D. thesis, The Ohio State University.
[26]. Gehan EL Nabawy Ahmed Moawad. (2013). Nurses' perception of obstacles and supportive behaviors in providing end of life care to critically ill pediatric patients. Journal of Biology, Agriculture and Healthcare,Vol. 3, No.2, pp. 96-105.
[27]. Hales, S., Zimmermann, C., Rodin, G. (2008).“The quality of dying and death”. Archives of Internal Medicine, Vol. 68, No. 9, pp. 912-918.
[28]. Hamooleh, M. M., Borimnejad, L., Seyedfatemi, N., Tahmasebi. (2013). “Perception of Iranian nurses regarding ethics- based palliative care in cancer patients”. Journal of Medical Ethics and History of Medicine, Vol. 6, No.12, pp.2- 8.
[29]. Hebert, K., Moore, H., Rooney, J. (2011). “The Nurse Advocate in End-of-Life Care”. The Ochsner Journal, Vol. 11, No. 4, pp. 325-329.
[30]. Hedayat, K. M., Pirzadeh, R. (2001). “Issues in Islamic Biomedical Ethics: A Primer for the Pediatrician”. Pediatrics, Vol. 108, No. 4, pp. 965-971.
[31]. Heron, M. P., Hoyert, D. L., Sherry, L., Murphy, B. S., Jiaquan, xu., Kenneth, D., Tejada-Vera, B. (2009).“Deaths: Final Data for 2006”. National Vital Statistics Reports, Vol. 57, No.14, pp.1-135.
[32]. Hilden, J. M., Emanuel, E. J., Fairclough, D. L., Link, M. P., Foley, K. M., Clarridge, B. C. (2001). “Attitudes and practices among pediatric oncologists regarding end-oflife care: Results of the 1998 American Society of Clinical Oncology survey”. Journal of Clinical Oncology, Vol.19, No. 1, pp. 205-212.
[33]. Hinds, P. S., Oakes, L., Furman, W., Quargnenti, A., Olson, M. S., Foppiano, P. (2001). End-of-life decision making by adolescents, parents, and healthcare providers in pediatric oncology: Research to evidence-based practice guidelines. Cancer Nursing, Vol. 24, No. 2, pp. 122-134
[34]. Iglesias, M. E. L., Pascual, C., Bengoa Vallejo, R.B. (2012). “Obstacles and Helpful Behaviors in Providing Endof- Life Care to Dying Patients in Intensive Care Units”. Dimensions of Critical Care Nursing, Vol. 32, No. 2, pp. 99- 106.
[35]. Iranmanesh, S., Dargahi, H., Abbaszadeh, A. (2008a). “Attitudes of Iranian nurses toward caring for dying patients”. Palliative and Supportive Care, Vol. 6, No. 4, pp. 363–369.
[36]. Iranmanesh, S., Savenstedt, S., Abbaszadeh, A. (2008b).“Student nurses' attitudes towards death and dying in south-east Iran”. International Journal of Palliative Nursing, Vol. 14, No. 5, pp. 214–219.
[37]. Izumi, S., Nagae, H., Sakurai, C., Imamura, E. (2012). “Defining end-of-life care from perspectives of nursing ethics”. Nursing Ethics, Vol.19, No.5, 608–618.
[38]. Khader, K., Jarrah, S., Alasad, J. (2010). “Influences of nurses' characteristics and education on their attitudes towards death and dying”: A review of literature. International Journal of Nursing and Midwifery, Vol. 2, No.1, pp.1-9.
[39]. Kirchhoff, K. T., Beckstrand, R. L. (2000). “Critical care nurses' perceptions of obstacles and helpful behaviors in providing end-of-life care to dying patients”. American Journal of Critical Care, Vol. 9, No. 2, pp. 96-105.
[40]. Lange, M., Thom, B., Kline, N. (2008).“Assessing nurses' attitudes toward death and caring of dying Patients in a comprehensive cancer centers”. Oncology Nursing Forum, Vol. 35, No.6, pp 955-959.
[41]. Mehrdad, R. (2009). “Health System in Iran”. Japan Medical Association Journal, Vol. 52, No.1, pp. 69–73.
[42]. Mesukko, J. (2010). Critical care nurses' perceptions of quality of dying and death, barriers, and facilitators to providing pediatric end-of-life care in Thailand, Ph.D. thesis, Frances Payne Bolton School of Nursing. Case Western Reserve University. p11, 145.
[43]. Migrant Information Centre Melbourne Australia. (2009). Palliative Care for Culturally Linguistically divers communities. Cultural profiles to assist in providing culturally sensitive Palliative Care. Migrant Information Centre Melbourne Australia. http://www.eastpallcare.asn.au/.
[44]. Mobasher, M., Aramesh, K., Zahedi, F., Nakhaee, N., Tahmasebi, M., Larijani, B. (2014).“End-of-Life care ethical decision making: Shiite scholar views”. Journal of Medical Ethics and History of Medicine, Vol. 7 No. 2, pp. 2-11.
[45]. Mohamed Ali, W. G., Ayoub, N. S. (2010). “Nurses' Attitudes Toward Caring For Dying Patient In Mansoura University Hospitals”. Journal of Medicine and Biomedical Sciences, pp. 16-23.
[46]. Moss, A. H., Demanelis, A. R., Murray, J., Jack, J. (2005).“Barriers to quality end-of-life care in West Virginia ICU units: Physicians' and nurses' perspectives”. The West Virginia Medical Journal, Vol. 101, No.5, pp. 200-204.
[47]. Naidoo, V. (2011). Experiences of critical care nurses of death and dying in an intensive care unit: a phenomenological study, M.S thesis, Durban University of Technology.
[48]. Nelson, J. E. (2006). “Identifying and overcoming the barriers to high-quality palliative care in the intensive care unit”. Critical Care Medicine, Vol.34 (11 Suppl), pp. 324- 331.
[49]. Chen, C., Huang, L.C., Liu, H.L., Lee, H.Y., Wu, S.Y., Chang, Y.C., Peng, N.H. (2012). “To Explore the Neonatal Nurses' Beliefs and Attitudes Towards Caring for Dying Neonates in Taiwan”. Maternal and Child Health Journal, Vol.17, No.10, pp. 1793-801.
[50]. Ott, B.B., Al-Khadhiri, J., Al-Junaibi, S. (2003). “Preventing ethical dilemmas: the Muslim people”. Pediatric Nursing, Vol. 29, No.3.
[51]. Razban, F., Iranmanesh, S andRafiei, H. (2013).“Nurses' attitudes toward palliative care in southeast Iran”. International journal of palliative nursing, Vol.9, No.8, pp. 403-10.
[52]. Steinberg, S. M. (2011). “Cultural and religious aspects of palliative care”, International Journal of Critical Illness and Injury Science, Vol1, No.2, pp. 154-6.
[53]. Taleghani, F., ParsaYekta, Z., Nasrabadi, A.N. (2005).“Coping with breast cancer in newly diagnosed Iranian women”.Journal of Advanced Nursing Vol. 54, No. 3, pp. 265-73.
[54]. www.ecosecretariat.org/ftproot/MDG/Chapter %204%20-%20Iran.pdf. Retrieved May 2014.
[55]. www.who.int/country/irn/en 2012. Retrieved May 2014.
If you have access to this article please login to view the article or kindly login to purchase the article

Purchase Instant Access

Single Article

North Americas,UK,
Middle East,Europe
India Rest of world
USD EUR INR USD-ROW
Pdf 35 35 200 20
Online 35 35 200 15
Pdf & Online 35 35 400 25

Options for accessing this content:
  • If you would like institutional access to this content, please recommend the title to your librarian.
    Library Recommendation Form
  • If you already have i-manager's user account: Login above and proceed to purchase the article.
  • New Users: Please register, then proceed to purchase the article.